Clips have been devised for clamping or strangulating various organs, vessels, and other tissue. Clips have been developed for use specifically in strangulating blood vessels in the human body. Such clips are known as hemostatic or ligating clips. The clips may be fabricated from absorbable or nonabsorbable polymeric materials as well as from metal.
A ligating clip is typically C-shaped, U-shaped, or V-shaped with two spaced-apart or diverging legs connected together at one end in a manner that permits the clip to be squeezed together so that the legs of the clip may be clamped around the tissue or blood vessel so as to tightly constrict the tissue or blood vessel. This prevents a substantial amount of fluid from passing through the tissue or blood vessel from one side of the closed clip to the other side of the closed clip.
Typically, the clip is made of a material and/or has a configuration that enables the clip, once it has been forced closed, to remain set or latched and maintain the closed orientation without outside intervention. For example, if the clip is made from a metal material, the clip can be deformed to the closed position. If the clip is made from a thermoplastic material, the legs may be connected by a resilient hinge portion and the distal ends of the legs may be provided with latch means for holding the legs together in a closed position when the legs of the clip are squeezed together around the tissue or blood vessel.
Various novel ligating clips are disclosed in copending U.S. patent applications assigned to the assignee of the present invention: Ser. No. 208,368, filed on Nov. 19, 1980; Ser. No. 276,131, filed on June 22, 1981; Ser. No. 277,582, filed on June 26, 1981; Ser. No. 277,454, filed on June 26, 1981; Ser. No. 282,461, filed July 13, 1981; and Ser. No. 296,672, filed on Aug. 27, 1981.
Some types of surgical clips have been proposed wherein one of the legs of the clip is especially adapted for being engaged by, and supporting the clip in, an applier instrument. See, for example, U.S. Pat. Nos. 3,780,416 and 3,882,854 which each disclose an asymmetric clip having two differently shaped legs with one of the legs being adapted to be received in a carrier or lower jaw of the applier instrument.
It would be desirable to provide a ligating clip which couldt be easily applied by an instrument to tissue, such as a blood vessel and the like. Further, it would be desirable to provide such a clip with a configuration that would permit a plurality of such clips to be loaded into, and contained within, the instrument for applying the clips. Further, it would be beneficial if the clip could be accommodated in the instrument and moved forward within the instrument to the clip applying jaws of the instrument by a relatively simple and trouble free mechanism. Also, it would be advantageous if such a clip had a configuration which would permit it to be restrained within the clip applying instrument and to be guided by the clip applying instrument to the jaws of the instrument.
A variety of instruments for applying such surgical clips have been developed or proposed in the past. A number of such instruments are discussed and disclosed in the copending patent application Ser. No. 208,368, filed on Nov. 19, 1980. Such instruments typically include a magazine or cartridge which may or may not be disposable and which holds a plurality of clips. The clips are supplied from the cartridge to jaws of the instrument one at a time for application to the tissue or blood vessel.
U.S. Pat. No. 3,006,344 discloses an instrument for applying a ligating clip to a blood vessel. The clip is formed of flat metal or like stock and has a pair of legs extending outwardly in a generally V-shape. The clips are arranged in two parallel grooves in a magazine. A slide is positioned in each groove and is urged by a suitable conventional spring to advance the clips along the magazine toward the jaws. The clips are arranged in each row with the distal end of one of the legs of one clip abutting the rear connecting hinge portion of the next adjacent clip.
U.S. Pat. No. 3,753,438 discloses an applicator for applying clips to suturing thread during the suturing of skin wounds. The clips are carried in a cartridge in the instrument. A clip is forced forwardly from the cartridge to a position between the instrument jaws by a slide which is operated by a handle. After the clip is positioned within the jaws, the handles of the instrument are squeezed together to squeeze the clip legs together.
It would be desirable to provide an improved instrument for accommodating a plurality of ligating clips and for automatically feeding the clips seriatim into jaws where a clip can be compressed about tissue, such as a blood vessel or the like. Further, it would be advantageous if the clips could be retained within the instrument and moved forward within the instrument toward the jaws of the instrument by an effective, yet relatively simple, mechanism. Additionally, it would be desirable to provide means in the instrument for ensuring that only one clip at a time is positioned in the jaws of the instrument for application to the tissue.